Title: Nursing in the New Millennium
1Nursing in the New Millennium
- Phyllis M. Connolly PhD, APRN, BC, CS
2Nursings responsibility is awesomein patient
care and also in creating a new society (Nyberg,
1998, p. 209)
33 Assumptions
- Life at warp speed
- New type of change, age of unreason
- Constant change, permanent white water
4Changing Work Environment
- Technology
- Demographics
- Managed Care
- Purchasers Influence
- Health Insurance Industry
- Changing Health Systems
5Report Card Managed Care
- Access
- Quality/Appropriateness
- Promotion/Prevention
- Outcomes
- General health improved
- Quality of life improved
- Treatment reduces psychological stress
- More productive independent
6ANA Initiatives Improve Quality of Health Care
- 1994 Nursings Safety and Quality Inititive
- 1996 Nursing-Sensitive Quality Indicators for
Acute Care Settings - 1997 National Data Base of Nursing Indicators
(NDQI) - CalNOC largest ongoing nursing quality
measurement data set in nation
7IOM (2001)Crossing The Quality Chasm Changes
Needed
- Safe
- Effective
- Patient-centered
- Timely
- Efficient
- equitable
8IOM Rules for Redesign (2001)
- Care is based on continuous healing relationships
- Care is customized according to patient needs
values - The patient is the source of control
- Knowledge is shared information flows freely
- Decision making is evidence-based
9IOM (2003) Keeping Patients Safe Transforming
the Work Environment of Nurses
- Address management practices
- Workforce capability
- Work Design
- Organizational safety culture
10Impact of Nursing Studies Patient Outcomes
- Needleman et al.(2002) 1997 data
- ? hrs care/day RNs medical pts.
- ? LOS, rates of UTI, UGI bleeding, pneumonia,
shock or cardiac arrest failure to rescue - ? hrs. care/day RNs surgical pts.
- ? UTI, failure to rescue
- Aiken et al.(2003)
- 10 ? in proportion of BSN
- ? 5 risk of patient death failure to rescue
11Strategies Skills For Future
- Ability to understand systems
- Critical thinking, analysis and problem solving
- Reframing
- Personal growth mastery, ability to tolerate
ambiguity take risks - Emotional intelligence self-restraint (impulse
control) compassion
12Strategies Skills For Future Cont.
- can do spirit
- Business leadership intelligence
- Ability to manage change
- Group management skills, negotiating conflict
resolution - Stewardship
- Collaborative leadership skills
13AACN Role New Clinical Nurse Leader (Summary
draft 2003)
- Clinician Leadership in care of sick across all
environments - Outcomes manager
- Client Advocate
- Educator
14AACN Clinical Nurse Leader Role Cont.
- Information manager
- Systems analyst/Risk Anticipator
- Team Manager
- Member of Profession
15- To be active participants in shaping the health
care system, nurses must learn new skills - Alderman (2001, p. 50)